A digital intervention to enhance engagement with oral oncolytic treatments and assess patient experiences with novel therapies.

Adherence to oral oncolytic therapy influences treatment efficacy and outcomes. Effectively managing adherence requires a clear understanding of how treatments impact the patient. By directly monitoring adherence through precise dose administration data and electronic patient-reported outcomes (ePROs) using ReX, clinicians can improve outcomes while enhancing overall care quality and experience. We aimed to assess the impact of ReX on oral therapy adherence, dose reductions, and treatment discontinuations in real-world practice. Patients at 1 large community practice and 4 academic health systems were included in this retrospective cohort analysis. Participants all had either: chronic lymphocytic leukemia, and initiated treatment with acalabrutinib on or after September 12, 2023, or hormone receptor-positive, HER2-negative metastatic breast cancer who initiated ribociclib on or after May 22, 2024. Control data was abstracted from charts within the practices from those who did not receive the ReX device. Medication was dispensed as standard of care in ReX (Dosentrx Inc), an FDA approved handheld pocket-sized device. At a programmable time, patients take their medication from ReX and are asked ePROs about side effects via a touch screen on the device. Pill intake data and ePROs were available on the ReX Therapy Manager, a cloud-based platform. A total of 35,760 pills were taken and 16,885 ePROs answered; resulting in 95% dosing adherence and 97% ePRO engagement (total questions answered/questions presented) in those using ReX. Ribociclib control (median age 56, all female), ribociclib ReX (median age 53, all female), acalabrutinib control (median age 73, 60 males and 33 females), and acalabrutinib ReX (median age 70, 49 males and 32 females). Patients using ReX had fewer dose reductions and discontinuations compared to the control group (Table 1). This data suggests that ReX leads to high adherence and ePRO engagement rates, resulting in fewer dose reductions and significantly greater persistence of both acalabrutinib and ribociclib use in community and University settings. Future studies with a greater sample size will be needed to confirm these endpoints and assess the impact of lower discontinuation rates on health outcomes.

Duke Scholars

Author Thomas William LeBlanc Medicine, Hematologic Malignancies and Cellular Therapy